We carried out a review of the data available to us about ARCH Care Services Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about ARCH Care Services Ltd, you can give feedback on this service.
Arch Care Services Ltd provides personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection there were 65 people receiving support with their personal care.
People’s experience of using this service and what we found
Medicines were administered when required and records had clear guidance for staff to follow. Staff had checks undertaken prior to starting work within the service. Staff were familiar with different types of abuse and who to raise concerns with. People and relatives felt the service was safe. Incidents and accidents were recorded including actions taken. People’s care plans had risk assessments and guidance for staff to follow should a risk be identified.
Staff had received training in the use of personal protective equipment (PPE). People confirmed staff washed their hands and they used PPE as required. Most people knew their staff well, however on occasions people experienced care delivered by staff who were not familiar to them. Staff felt supported and told us it was a nice place to work. People’s views were sought, and people felt able to raise any issues with staff in the office. Not everyone was familiar with who the registered manager was. Audits were in place that checked medicines, care delivery, safeguarding and incidents and accidents. There was provider oversight of these audits.
Rating at last inspection: The last rating for this service was requires improvement (published 4 October 2019).
Why we inspected
We carried out a comprehensive inspection of this service on 10 July 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do to improve the safe recruitment of staff.
We undertook this focused announced inspection of this service on the 21 April 2021. This was to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, which contain those requirements and Well-led.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arch Care Services Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service:
People felt safe however improvements were required to pre-employment safety checks and guidelines for people who required staff to administer creams. Some people received care from staff who they were unfamiliar with and who at times were not on time. Risk assessments confirmed people’s support needs and identified risks. Staff demonstrated a good understanding of infection control procedures and demonstrated this in practice.
The service was effective in meeting people’s needs. Staff felt supported and they received training and supervision in order to meet people’s individual needs. People were supported to attend medical reviews or to see a GP and other healthcare professionals when required. People’s care plans contained important information relating to their mental capacity.
People were supported by staff who had a good understanding of equality and diversity and people’s care plans reflected people’s wishes. Staff demonstrated how they gave people choice and how people made choices about their care. Most people had built a positive relationship with staff who they knew well.
The provider and registered manager were not accurately registered with us. This was due to the office location moving. Action was taken during the inspection. The registered manager monitored the quality of the service however shortfalls relating to pre employment checks and medication records hadn't been identified as requiring improvement prior to our inspection. Staff felt supported and happy working in the service. People’s views were sought so that improvements could be made to the care they received. The registered manager also monitored feedback so that improvements could be made.
Rating at last inspection: Good (published January 2017).
Why we inspected: This was a planned inspection based on previous rating. At this inspection the service had deteriorated and the overall rating had changed to Requires Improvement.
Enforcement: We have identified one breach in relation to the failure to ensure staff had adequate checks undertaken prior to undertaking employment.
Please see the action we have told the provider to take at the end of this report.
Follow up: We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People were kept safe and free from harm. People using the service, and staff, had access to a 24 hour ‘on-call’ service, which meant they could ask for guidance or additional support at any time.
The provider had a robust recruitment process which minimised the risks of abuse to people. Staff had received training and information on how to recognise and report any suspicions of abuse and they were confident any concerns would be acted on promptly.
There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes to appointments as requested by the person who used the service or their relatives. One person said, “I sometimes need help outside of my usual hours and they have always tried to get to me as soon as they can.” People were confident staff were never rushed and always stayed for the correct length of time.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. There were systems in place to ensure people received their medicines safely from staff who were trained and competent to carry out the task. Continuous observation and auditing ensured these systems were maintained and action taken to minimise the risk of errors, for example additional training for staff.
Staff knew the people they were supporting and provided a very personalised service. Care plans were in place detailing how people wished to be supported and people and/or their relatives were involved in making decisions about their care. People told us they liked the staff and found the care to be good. Peoples’ comments included, “ They [the staff] understand me and know about my needs. They make my life easier and take the pressure off me” and ““They cater to my every whim!”
People were supported to eat and drink if required. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. For example, they contacted social services and occupational therapists if people’s care needs increased and they required more time or equipment. Care plans were reviewed regularly which meant staff were able to continue to meet people’s needs as they changed. Effective communication systems ensured that this information was shared promptly with the person and the team supporting them, with the person’s consent.
Staff had received training and had an understanding of the requirements of the Mental Capacity Act (2005) (MCA), which meant people’s legal rights were protected. People who used the service and others involved in their care were fully involved and consulted. People were always asked for their consent before staff assisted them with any tasks. Staff respected people’s privacy and people were treated with respect and dignity. The service had developed a ‘Dignity Champion’ role and produced a Dignity in Care newsletter. People’s comments reflected a focus on personal care provided in a way that maintained their dignity. Comments had included how people receiving the service helped to make them feel ‘human’ and cared for.
Due to the commissioning process the service had recently lost the tender to provide care to some people. This meant that unless people were privately funded or used a direct payment scheme they would soon have their care needs met by a different agency. Everyone we spoke to said they would prefer to remain with ARCH where possible and were very happy with the personalised service provided.
There was a registered manager who managed the service well. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager was clearly well liked by people using the service and staff. They were accessible and approachable. Staff, people who used the service and relatives felt able to speak with the registered manager and there were opportunities to provide regular feedback on the service. The registered manager/provider had a ‘hands on’ approach and had developed positive relationships with people who used the service and their families and continued to look for improvements. For example, the service had an allotment where staff invited people to come and help with gardening as a social event free of charge. Staff told us they were well supported by them.
There were effective systems in place to monitor the quality of the service, including regular spot checks, audits and regular satisfaction surveys for people who used the service and staff. The focus was on being open and transparent and continuing improvement for the benefit of people who used the service.
People received support with medicines in ways that had been agreed and which promoted their independence. There were procedures in place so that support with medicines and personal care was provided in a safe way. Portable hoists for example were being checked to ensure that they were in a safe condition.
The office based staff we spoke with were clear about their roles and responsibilities. We saw that there was good communication between the people who used the service, the care workers and the office based staff. The agency had effective systems in place for monitoring the quality of service that people received. Overall, we found that people were receiving a well run service that met their needs.
The people who used the service we spoke with told us staff treated them with respect and dignity. Staff gave us good examples of how they supported people to maintain their independence and dignity.
People said they received the care that they needed. One person told us, "the carers are very good and I am happy with the service'.
We found the provider reviewed people's needs and planed their care to ensure that people received safe care. For example, there was a risk assessment and care plan to support a person with a mobility need in order to reduce the risk of falling.
People told us that they felt safe with the support workers who visited them. We found that systems were in place to ensure people were safeguarded from abuse.
We found that staff were trained and supported to deliver care to an appropriate standard.
We found that the provider had an effective system in place to monitor the quality of the service, to ensure that people received safe care.
We saw the agency had effective complaints system in place and complaints people made were responded to.